Fig 10.

Various 3D DSA examples of segmental ICA dysplasia. In traditional classifications, case 1 may be described as 3 separate aneurysms—distal cavernous (or transitional) and superior- and inferior-pointing superior hypophyseal aneurysms. We consider all of these as focal expressions of disease affecting the entire paraophthalmic segment. Case 2 may be considered as a discrete carotid-ophthalmic aneurysm; notice, however, the irregular, expanded morphology of the parent vessel below the “neck.” Case 3—apparently separate clinoid and ophthalmic aneurysms—can also be viewed as segmental dysplasia with a single aneurysm separated by the anterior clinoid process. Case 4 is a giant fusiform aneurysm spanning the entire carotid artery from cavernous to terminus segments.